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You are seeing a 15yo patient with past psychiatric history who takes escitalopram (Lexapro) and quetiapine (Seroquel) for nausea and vomiting. You give the patient a dose of ondansetron (Zofran) and an IV fluid bolus, then discharge him home with a prescription for ondansetron. His parent gives him diphenhydramine (Benadryl) before bed to help him fall asleep. He becomes upset and overdoses on one of the medications in the home.Â
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March 2, 2021 at 10:15 pm
E) All of the above
All of the drugs listed are associated with severe QTc prolongation in overdose. Others include: amitriptyline, bupropion, citalopram, doxepin, haloperidol, imipramine, nortriptyline, sotalol, and trazadone. (Campleman SL, Brent J, Pizon AF, Shulman J, Wax P, Manini AF; Toxicology Investigators’ Consortium (ToxIC). Drug-specific risk of severe QT prolongation following acute drug overdose. Clin Toxicol (Phila). 2020 Dec;58(12):1326-1334. doi: 10.1080/15563650.2020.1746330. Epub 2020 Apr 7. PMID: 32252558)